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WISQARS Cost of Injury Reports with New Enhancements Lee Annest, PhD Office of Statistics and Programming National Center for Injury Prevention and Control Centers for Disease Control and Prevention May 4, 2012 National Center for Injury Prevention and Control

Office of Statistics and Programming Office of the Director - Lee Annest, PhD, Director - Lisa Kiser, AS, Deputy - Tad Haileyesus, MS - Ann Smalls Statistics Team - Marcie-jo Kresnow, MS (lead) - George Ryan, PhD - Scott Kegler, PhD (EIS/SAS) Larry Yang BNL consulting (sub) - Rob Lill - Mike Arnett (PIRE) Dr. Ted Miller - Dr. Bruce Lawrence - Dr. Phaedra Corso (consultant) Programming Team - Kevin Webb (lead) - Bob Thomas, MSIM - Dionne Williams, MPS - Darryl Owens, BS - Lily Xi, MS (contractor) (HCSO) Wendy Holmes - Stacey Thalken - Graham Kirkland - Jennifer Forberg

Outline Data Sources Components of the Cost module Example Scenario using Unintentional Motor Vehicle- - Traffic Deaths In Mississippi.

Fatal and Nonfatal Injuries in the United States http://www.cdc.gov/injury/wisqars $$$ WISQARS-Cost of Injury Reports Available to the public February 24, 2011 Enhancements: April 25, 2012

Data Sources Deaths - NCHS National Vital Statistics System Underlying Cause data for Intent X Mechanism Multiple Cause data for Body Region X Diagnosis Nonfatal Injuries National Electronic Injury Surveillance System All Injury Program Unit lifetime medical and work loss cost estimates produced by Dr. Ted Miller and colleagues at the Pacific Institute t for Research and Evaluation (PIRE), Calverton, MD

Overview of Cost Module Measures of Cost 2005 Lifetime Medical Costs (treatment & rehab) 2005 Lifetime Work Loss Costs (lost wages, fringe benefits, and lost household work) 2005 Lifetime Combined (Medical + Work Loss) Costs (NOTE: Cost estimates do not include property damage, pain/suffering, loss quality of life, litigation, and other costs. For injury-related deaths, lifetime medical costs refer to the medical costs associated with the fatal injury event.)

Overview of Cost Module Injury Outcomes Deaths Nonfatal Hospitalizations ti Nonfatal Emergency Department Visits Treated and Released (N t F f t l h it li ti t ti t li it d t (Note: For nonfatal hospitalizations, cost estimates are limited to injured persons initially treated in the ED.)

Overview of Cost Module Injury/Demographic Reporting Options Intent X Mechanism of Injury (E-code matrix) Body Region X Nature of Injury (Diagnosis/Barell s/ ae matrix) Geographic location Sex U.S., Region, State for injury deaths U.S. only for nonfatal injury hospitalizations/ed visits T & R All Ages, 5-year Age Groups, Custom Age Range (Note: Race/Ethnicity is not offered as an option in the module.)

Overview of Cost Module Part I Cost Statistics Total Costs for 2005 in year 2005 prices for all injuries covered in the report Average Costs per injury for 2005 in year 2005 prices (Note: we plan to update the module with more current data and pricing in the future.)

Overview of Cost Module Part I Pricing 2005 U.S. Prices (Deaths/Hospitalizations/ED-T&R) 2005 Regional Prices (Deaths only) 2005 State Prices (Deaths only) (Note: Medical price adjusters (indices) were derived from the ACCRA 2007 Cost of Living Index (Council for Community and Economic Research) and population statistics from the U.S. Census Bureau; wage adjusters were computed using wage information from the U.S. Bureau of Economic Analysis, Survey of Current Business, 2008.)

Overview of Cost Module Part I Cost of Injury Computations Each injury death, hospitalization, ED visit T&R) was assigned a unit medical cost and a unit work loss cost Total costs = unit costs of selected incidents Average costs = Total costs total # of selected incidents (i.e., average costs per injury death or per nonfatal injury case). Table provides # of incidents, average costs, total costs. (Note: Some factors considered in assigning unit costs: mechanism, intent, nature of injury, body region, place of death, sex and age. (See help file/methods report for details)

Overview of Cost Module Part II Customized Cost Statistics Enters your own case counts (e.g. county-level injury death counts by year) Total cost estimate = case counts X average costs per person from national data sources based on 2005 data in year 2005 prices from the Cost module Part I) Index costs to same or a different year (up to 2010) based on CPI for medical care (medical costs) and the Total Compensation Index (work loss costs) Automatic statistical checks for instability of systemgenerated average cost estimates ( coefficient of variation; case count)

Cost of Injury Reports, Part I

Cost of Injury Reports, Part I

Facts: Example Scenario Mississippi Highest age-adjusted adjusted Unintentional MV-traffic death rate in the U.S. in 2009 (rate: 24.2 per 100,000 vs 11.1 (U.S.)) Persons ages 15-24 years have highest rate (39.0) Number of Unintentional MV-traffic deaths dropped 18.4% among 15-24 years from 2005 to 2009. What is the difference in estimated total lifetime medical care costs in 2009 compared to 2005 associated with deaths in this age group?

Cost Module User Interface

Intent X Mechanism: Unintentional Motor Vehicle Traffic Deaths

Intent X Mechanism: Unintentional Motor Vehicle Traffic Deaths

Unintentional Motor Vehicle Traffic Deaths Stable Unstable Stable

Intent X Mechanism: Unintentional Motor Vehicle Traffic Deaths

Unintentional Motor Vehicle Traffic Deaths, Ages 15-24 years. Mississippi, 2005, 2009

Uninintentional Motor Vehicle Traffic Deaths Ages 15-24 Years Uninintentional Motor Vehicle Traffic Deaths, Ages 15 24 Years, Mississippi, 2005

Uninintentional Motor Vehicle Traffic Deaths, Ages 15-24 Years, Mississippi, 2005

Unintentional Motor Vehicle Traffic Deaths, Ages 15-24 Years, Mississippi, 2009

Uninintentional Motor Vehicle Traffic Deaths, Ages 15-24 Years, Mississippi, 2009

Unintentional Motor Vehicle Traffic Deaths, Ages 15-24 Years, Mississippi, 2005, 2009 Year and Sex No of Deaths 2005 Males 151 Females 61 Both Sexes 212 2009 Males 118 Females 55 Both Sexes 173 Reduction in Number of Deaths = (1 (173/212))*100 = 18.4% Total Lifetime Medical Costs Savings (based on 2010 prices) = ($1,329,000 (2005) - $1,075,000 (2009)) = $254,000

Summary WISQARS Cost of Injury Reports module enhancements can be useful for computing: Total lifetime medical and work loss costs: - Using national data provided by WISQARS - Using user-provided counts of injury death or nonfatal injury cases multiplied times average costs from national data sources. Cost savings of total lifetime medical and work loss costs for State and local subpopulations of interest

Thank you! Lee Annest, PhD lannest@cdc.gov Phone: 770.488.4804 For more information please contact Centers for Disease Control and Prevention 1600 Clifton Road NE, Atlanta, GA 30333 Telephone: 1-800-CDC-INFO (232-4636)/TTY: 1-888-232-6348 E-mail: cdcinfo@cdc.gov Web: http://www.cdc.gov The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.